The Predictive Value of the Combination of Soluble ST2 and N Terminal-Pro Brain Natriuretic Peptide for Short-Term Mortality in ST-Elevation Myocardial Infarction Patients with Poor PostProcedural TIMI Flow

2019 ◽  
Vol 22 (3) ◽  
pp. 168-176
Author(s):  
Mustafa Umut Somuncu ◽  
Tunahan Akgün ◽  
Belma Kalaycı ◽  
Nail Güven Serbest ◽  
Hüseyin Karakurt ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Predictive Value ◽  
St Elevation Myocardial Infarction ◽  
Short Term ◽  
Soluble St2 ◽  
Timi Flow ◽  
Short Term Mortality ◽  
St Elevation

scholarly journals Role of soluble ST2 in short-term prediction of acute heart failure in acute ST-elevation myocardial infarction

2021 ◽  
Vol 26 (4) ◽  
pp. 4308
Author(s):  
O. S. Donirova ◽  
K. V. Protasov ◽  
B. A. Donirov ◽  
E. V. Batunova
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Brain Natriuretic Peptide ◽  
Acute Heart Failure ◽  
Natriuretic Peptide ◽  
Predictive Value ◽  
St Elevation Myocardial Infarction ◽  
Left Ventricular Ejection ◽  
Soluble St2 ◽  
St Elevation

Aim. To investigate the relationship of soluble ST2 (sST2) to acute heart failure (AHF) and compare the predictive value of sST2 and brain natriuretic peptide in patients with ST-elevation myocardial infarction (STEMI).Material and methods. In 136 STEMI patients, the serum sST2 concentration was determined during the first 24 hours of hospitalization. We assessed levels of sST2, N-terminal pro-brain natriuretic peptide (NT-proBNP), incidence of Killip class II-IV AHF during hospitalization, myocardial necrosis biomarkers, parameters of complete blood count and biochemical blood tests, the incidence of cardiovascular diseases and risk factors. The predictive value of sST2 for AHF development was assessed using logistic regression. ROC analysis was performed. The areas under the ROC curve were compared for sST2 and NT-proBNP. The cut-off sST2 value was determined for predicting AHF.Results. The mean sST2 level was 43,4 (33,6-73,9) ng/ml. During the followup period, AHF was diagnosed in 54 people (39,7%). The prevalence of AHF in the 1st, 2nd and 3rd tertiles of sST2 was 15,6%, 33,3% and 69,7%, respectively. The NT-proBNP levels were 319 (128-1072) pg/ml, 430 (147-1140) pg/ml and 1317 (533-2386) pg/ml. The predictive value of 3rd sST2 tertile was retained adjusted for age, sex, NT-proBNP, troponin T, creatine phosphokinase-MB, high-sensitivity C-reactive protein, hemoglobin, blood glucose, left ventricular ejection fraction. The areas under the ROC curves for sST2 and NT-proBNP were comparable (0,828 and 0,733, respectively; p=0,056). The cut-off sST2 value was 64 ng/ml, above which the odds ratio of AHF was 11,1 (95% confidence interval, 4,7-26,1.Conclusion. An increase in blood sST2 is associated with an increase in AHF (Killip II-IV) prevalence in hospitalized patients with acute STEMI. Soluble ST2 has an independent predictive value for AHF in STEMI, comparable in strength and predictive model quality to NT-proBNP. The cut-off sST2 value for AHF (>64 ng/ ml) was calculated, which provides an optimal balance of sensitivity, specificity and accuracy of the prognostic model. These data support the potential value of sST2 as a biomarker of AHF in STEMI.

scholarly journals A Study of N-terminal pro-Brain Natriuretic Peptide as a Predictor of Adverse Outcome of STEMI

2016 ◽  
Vol 11 (1) ◽  
pp. 13-17
Author(s):  
Mohammad Zakir Hossain ◽  
Md Abu Siddique ◽  
Tanjima Parveen ◽  
Manzoor Mahmood ◽  
Khandaker Aisha Siddika ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Troponin I ◽  
Adverse Outcome ◽  
Venous Blood ◽  
St Elevation Myocardial Infarction ◽  
Prognostic Information ◽  
Prediction Of Mortality ◽  
St Elevation

Background: Mortality risk is quite variable among fibrinolytic treated ST elevation myocardial infarction patients. Careful and early risk evaluation of each patient is therefore important. Until now, the most evaluated biomarker has been troponin I on admission, which gives strong prognostic information. NT pro BNP has shown reasonable promise in predicting the adverse outcome of STEMI. This research will provide the information regarding its efficacy as a predictor of adverse outcome following STEMI. Objective: To assess the prognostic value of N-terminal pro-brain natriuretic peptide in fibrinolytic treated ST elevation myocardial infarction (STEMI) patients. Method: This short term prospective study was done in Cardiology dept. of BSMMU. We valuated 115 patients of STEMI admitted within 12 hours and receiving thrombolytic therapy. Venous blood sample was collected for NT pro BNP before starting fibrinolytic therapy. Additional clinical data was recorded including detailed complications of STEMI. Results: Out of 115 patients of STEMI 32.2% patient had adverse outcome among them 9.6% patients died, heart failure 13.0%, cardiogenic shock 7.8%, VT & VF 5.2%, acute MR 2.6%, VSR 0.9%, CHB 2.6% and 67.8% patient had no adverse outcome. According to association between hospital outcomes with N-terminal pro BNP level, it was observed that the mean Nterminal pro BNP level was higher in adverse outcome group. Based on the receiver-operator characteristic (ROC) curves N-Terminal Pro BNP level gave a cut off value ?480.0 pg/ml, with 88.5% sensitivity and 100.0% specificity for prediction of complications and similarly N-terminal pro BNP level gave a cut off value ?725.5 pg/ml, with 72.7% sensitivity and 93.3% specificity for prediction of mortality. Conclusion: N-Terminal Pro BNP level was highly sensitive and very much effective in the evaluation of adverse outcome of fibrinolytic treated ST elevation myocardial infarction (STEMI).University Heart Journal Vol. 11, No. 1, January 2015; 13-17

scholarly journals Relationship between age and the impact of revascularization on mortality in patients with non-ST-elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Asano ◽  
Y Mitsuhashi ◽  
J Yamashita ◽  
R Ito ◽  
M Saji ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Medical Treatment ◽  
Coronary Revascularization ◽  
The Elderly ◽  
St Elevation Myocardial Infarction ◽  
Hospital Death ◽  
Short Term ◽  
Short Term Mortality ◽  
St Elevation ◽  
The Impact

Abstract Background It is known that the early coronary revascularization in patients with non-ST-elevation myocardial infarction (NSTEMI) was associated with favorable clinical outcomes. However, it is still unclear whether this efficacy is equivalent over all the ages of the patients. Methods Patients with NSTEMI were screened from the database of the Tokyo CCU network registry. Of those, the patients treated without revascularization (medical treatment) were matched with the patients receiving revascularization by propensity score matching. The probabilities of in-hospital death were calculated in the logistic regression model. In two subgroups stratified according to median of the age (elderly and non-elderly subgroups), the odds ratios of revascularization for in-hospital death were calculated. Results In the patients registered between 2013 and 2017, 4,851 patients with NSTEMI were identified. After the screening, 370 patients with medical treatment were matched with 370 patients treated with revascularization. The incidence of in-hospital death was significantly higher in the patients with medical treatment (20.3% vs 13.0%, P=0.01). The two probability curves of in-hospital death in patients with and without revascularization converged as age increased. In the elderly subgroup, the revascularization was not significantly associated with favorable outcome of mortality, whereas it had a significant impact on mortality in the non-elderly subgroup (odds ratio: 0.47 [95% CI 0.23–0.95]). Conclusion The impact of revascularization on short-term mortality in patients with NSTEMI tended to be reduced as age increased. Funding Acknowledgement Type of funding source: None

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